2016 Annual Report

Chugachmiut

A Tribal Organization Serving The Chugach Native Peoples of Alaska

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Chugachmiut is the Tribal consortium created to promote self-determination to the seven Native communities of the Chugach Region. We provide health and social services, education and training, and technical assistance to the Chugach Native people in a way which is ac-ceptable to Native cultural values and tradition in order to enhance the well-being of our people by continuing to strengthen the tribes and increase self-determination opportunities for community operated tribal programs.

Mission

Building on the inherent strength from our cultural values, Chugachmiut shall work to help member tribes achieve their chosen destiny.

Vision

Chugachmiut acknowledges the traditional cultural values of the seven Tribal communities in the Chugach Region. They include the following:

•Respect •Cultural Pride •Sharing •Teaching •Self-Discipline •Language •Humor •Cooperation •Loyalty •Spirituality

Values

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Table of Contents Letter From The Executive Director 4

Administration 5

Community & Family Services 6

Health Services 8

Heritage 10

Tribal Services 12

Trust & Forestry 13

Financial Summary 14

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LETTER FROM THE EXECUTIVE DIRECTOR

Dear Friends: Chugachmiut continues to build its organizational resilience in accordance with strong mission and vision statements that draw on our core values and strengths. Our vision is supported by an ambitious strategic plan that aligns initiatives in four critical areas: world class direct services, sustainability for Chugachmiut and its member tribes, stakeholder engagement, and continual improvement. I am very proud of the advanc-es we are making in all of these areas.

We are strengthening services by continually reviewing and improving our programs to ensure their accessibility, consistency, and relevance. We provide on-going training and education to staff result-ing in new ideas and increased creativity into the workplace, which have a positive impact on many different aspects of our services.

We are enhancing sustainability by building organizational and tribal government capacity. Strong systems and procedures eliminate the need to manage in crisis mode. This in turn builds trust and promotes planning which reinforces independence. Healthy people and communities are more likely to be self-sufficient and actively involved with improving the lives of everyone in the community.

We are working to engage stakeholders to protect their health and wellness by bringing local deci-sion-making into the hands of community members and conducting a survey to inform our actions to deliver excellence in service.

We are improving our quality in many ways to reflect our focus on improvements and innovation. The most prominent examples are described in the body of this report.

All of these advances are made possible by the Board of Directors and employees who have stepped up to support Chugachmiut. Together we are working to ensure that beneficiaries will be increasingly proud of their organization and that future generations will come to Chugachmiut to receive world class services. Regards, Angela Vanderpool Angela “Jan” Vanderpool Chugachmiut Executive Director

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Administration

Chugachmiut ended fiscal year 2016 with incredibly positive numbers; indirect collections met expenses, major pro-grams spent on track with zero or small deferred revenue amounts, and liabilities are minor. Chugachmiut greatly im-proved its financial stability as demonstrated by its latest audit report which contains no findings. The FY 2012 audit contained 12 findings which took time to completely resolve by reorganizing and strengthening our internal controls while at the same time repairing the massive amount of incorrect data and set up in the financial software. The Board of Directors (BOD) and Executive Director continue to closely monitor the situation but the burden is easing and we look forward to a solid future. Chugachmiut directly employs 149 people with 69 outside of Anchorage but in the region and 31 in close proximity to the region. We ‘pass thru’ funds to each of the tribes to employ 9 Tribal Administrators and Tribal Administrator Assistants within the region. We continue to provide technical assistance to all tribes in the areas of grant writing, grants management, human resources, and other office or governmental functions when requested. The BOD approved an experimental organizational flex schedule between the Memorial and Labor Day holidays last summer and made it a permanent employee benefit last fall. The pilot project was a resounding success and there was no diminishment or denial of services due to lack of staffing. The following is a comment received from an employee, “I just want to say thank you for making this possible. It meant a lot to me and my family. My Husband and I both work and have worked here in Seward for nearly 10 years, however we’ve not had an opportunity to have 2 whole days off together until this summer. Wow, that was great quality family time and thanks to Chugachmiut for making this possi-ble for me.” It’s been several years since a region wide program services survey was conducted, for that reason Chugachmiut is un-dergoing a survey. The survey will solicit information addressing the multifaceted programs and services provided by Chugachmiut. The survey and surveyors will assess the level of satisfaction of services and delivery of services provid-ed by Chugachmiut, as well as gather opinions on selected issues currently facing the villages. The results will help to shape local programs and services we offer to the community. At this point in time, Chugachmiut has over $4.7 million in grant funding; a substantial increase over previous years. The entire management team has been focused on research and development of grant programs that are linked to our mission and the strategic plan. We’ve been actively exploring every opportunity that arises and have written several proposals in the behavioral health, language, and culture preservation areas. We are slowly gaining ground after de-creases in grant funds over the past several years.

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Community & Family Services

Chugachmiut has reinstituted the Community & Family Services Division by joining Heritage, Behavioral Health, and other social services programs. The Division is taking a “no wrong door” approach to services where the whole person is served no matter the point of entry. Social Services covers food, heating, utilities, education, and jobs; Domestic Vio-lence Prevention Program covers safety and family health; Mental Health and Addictions Program covers mental and emotional well-being; Heritage programs go to the heart and soul of personal and community identities; and finally, we are looking at ways to pool experience and resources in the future, including grant writing and projects to support each of our communities. The Behavioral Health program provides top notch services. Including, a Crisis Line that provides 24/7 access to a pro-vider. The state Alcohol Safety Action Program (ASAP) reviewed our services and staff resulting in an award of a certif-icate to provide rehabilitation services. We’ve received both State and Federal recognition as a Community Behavioral Health Center (CBHC). With this recognition we now have the capacity to bill Medicaid, perform Title 47 assistance with suicidal and homicidal people, and to apply for new Federal and State grants that require applicants be state-certified CBHC’s. Behavioral Health staff had a greater presence in the schools in 2016. Staff presented to the youth in all of the classes within the schools on topics relating to substance abuse prevention, anti-bullying, respecting elders, and brought many healthy activities to the schools. The Behavioral Health Aides also had a larger presence in the schools with cul-tural awareness, teaching how to sew, plant uses, learning mutual respect, and other program presentations. Behavior-al Health Services have expanded to a point where even our smallest communities can expect a visit from a counselor at least once every two weeks. Chugachmiut reached a major milestone in its behavioral outpatient treatment for adults and children program; we were granted a one year accreditation by the Commission on Accreditation of Rehabilitation Facilities (CARF). Accredi-tation is an assessment by recognized experts that provides impartial verification of the quality of care, treatment or services. In addition to Chugachmiut’s routine improvement processes, preparing for accreditation gave us an oppor-tunity for an in-depth review of our safety and care delivery systems. Achieving accreditation is a visible demonstra-tion to those we serve, their families, our communities, the general public, and funding agencies of Chugachmiut’s on-going commitment to safe, high quality care, treatment and services. CARF sent two experts in behavioral health deliv-

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ery systems for a week-long survey of Chugachmiut. The team talked to board members, executive team members, behavioral health staff, and patients. The survey consists of four sections: Leadership, General Program Standards, Be-havioral Health Core Program Standards, and Behavioral Health Population Designation Standards. Each of the sec-tions contained a series of criteria Chugachmiut met, did not meet or were given an opportunity to correct within a specific timeframe. Many of the criteria were met or were already under development through the Board approved Strategic Plan or program improvements. For instance, in the Leadership area it was recommended that we develop and implement corporate compliance policies and procedures for compliance practices. That recommendation is al-ready a part of Chugachmiut’s strategic plan so, we simply revised our timeline to meet this recommendation in the allotted amount of time. In the summary section of the review report, the surveyors made many complementary points including the following: The organization is deeply rooted in the values, traditions, and customs of its cultures. The commitment to these

values demonstrated by the board, executive leadership, and staff helps provide holistic, effective, and satisfying services.

The organization has a strong, functioning board that understands and supports the work of Chugachmiut. The leadership of the organization has formulated its vision, strategic plan, and dedication to quality services. The

team has developed momentum to collectively create a powerful focus on quality improvement, teambuilding, and stakeholder engagement.

The persons served are appreciative of the services they receive. They had high praise for the treatment and sup-ports that have helped them to achieve their goals and feel that the experience is life-changing.

Because we met or had very minor improvements to make and can make them quickly, we were awarded a one-year certification. The CARF Team will be back at Chugachmiut this spring to conduct an additional review for a potential 2-3 year accreditation. The General Assistance program made improvements to better serve clients and to assure compliance with legal and regulatory obligations. One of the major upgrades of policies and procedures. The Board conducted a policy review and approved changes, some of which were to convert to a voucher system and, in conjunction with, local tribal coun-cils, development of a work/volunteer system for GA recipients.

Community & Family Services, continued

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Health Services

People get engaged on issues in which they have a personal stake, and are energized by seeing opportunity to improve their world. All people have the potential to create change in their communities and by joining together we can im-prove the health and wellness of our communities. Chugachmiut would like to shift the focus of health care from problem-based medicine to one of prevention and well-ness. A successful vision creates a compelling view of the future that provides a clear focus for leadership, supporters, and goals. The goal that “Chugachmiut will engage all stakeholders” was established in the Board appointed Strategic Plan. The first objective is to engage stakeholders in the design, delivery and evaluation of services. The first action is to form local committees with board representatives. Individuals appointed or volunteering to be part of the group pledge to devote time and attention to the activities of the committee and should have an interest in improving the health of the community. An initial committee meeting was held in Port Graham in January, participation was encouraged and open to everyone. Throughout 2016 we implemented technological enhancements and provided training opportunities for our staff and communities in an effort to improve care delivery:

Health Services- Chugachmiut was heavily involved in discussions about patient safety and electronic health rec-ords (EHR). Our voice was heard and carried through the Chugachmiut representative to the Consortium board resulting in them offering at no cost, all rural Anchorage Service Unit tribes and organizations to be incorporated into the Alaska Native Medical Center campus electronic medical record system, CERNER. On December 13, 2016,

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we transitioned to Cerner. This enables our healthcare team to enhance communication by sharing important in-formation about patient health in live time. For patients referred to ANMC or seen by ANMC specialists at field clinics, the shared electronic health record enhances the quality of care received and improves care team commu-nication and efficiency. Our Providers will now have complete documentation from an ANMC visit immediately available when a patient returns home.

Telemedicine– Telemedicine carts and care equipment was purchased and installed in our clinics. Through tele-medicine specialty care can be coordinated and collaborated with specialists during appointments at our clinics. Often times this technology is utilized when an emergency arises. To gain familiarity with the use and functionali-ty of the equipment participate in weekly meetings with ANTHC ER physicians to ensure during an emergency our care delivery team is familiar and comfortable with the equipment.

Community Health Aides- Chugachmiut was recently recognized by the Community Health Aide Program Certifi-cation Board for achieving 100% Community Health Aide/Practitioner certification (86% statewide). Currently all of our health aides are certified level III or higher. Three of our level III health aides are either waiting and/or pre-paring for session IV training.

Dental Services- During FY 2016, we provided dental services to 582 beneficiaries throughout our region. Within 2017, we will be incorporating silver diamine fluoride treatment in our program as an alternative dental treat-ment to shots and drills to kill tooth decay.

Diabetes Program- As part of the program, we are required to implement one best practice focused area for im-provement of diabetes prevention and treatment outcomes in communities and clinics. To assess improvement outcomes, each best practice includes one Required Key Measure (RKM) that we track and report on regularly. The key measure chosen was to increase nutrition education. Our team made a significant positive difference in providing nutritional education to our diabetic patient population and communities. From 2015 to 2016, we in-creased nutritional education by 12%, increased physical activity education by 22%, and education overall by 7%. We hosted Annual Health Events at Chenega Bay, Tatitlek, Port Graham and Seward, with more planned for 2017. The events were well attended and received overall positive event survey results. Also through grant funding, we purchased new exercise equipment and pedometers. Community Health Aides provided Diabetes Education in Tribal Schools (DETS) at local schools. Chenega Bay and Port Graham received consistent monthly trainings, Nan-walek received 2 trainings and staff training was provided in Tatitlek to support 2017 DETS classroom training.

Tobacco Prevention Control Program- Our Region’s tobacco use rates based off of tobacco use screenings have decreased overall from 2015 to 2016 by 19%. We will be gathering tobacco use data in the upcoming survey and hope to demonstrate even more improvement!

EMS Services- EMS transitioned to health service division oversight. We coordinated community wide EMS sce-narios within in each community in an effort to strengthen community and staff education, involvement, and sup-port. We purchased paramedic and EMS simulator mannequin (Sim Man) for the drills. Staff will be able to assess vitals, hook up an Automated External Defibrillator (AED), deliver the shock, perform CPR and our advanced practice providers practiced intubation. The vision is to continue the emergency drills until the process is seam-less for medical staff and community members.

Purchased and Referred Care- Implemented Medicare-like rate payments for services provided outside tribal health system contributing to overall cost savings.

Health Services, continued

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Heritage

Chugachmiut was awarded a Department of Education Alaska Native Education Programs grant of almost $7.5 million over 3 years. The grant provides 19 new jobs in the region. The goals of the grant are to provide instruction in Sugt’stun to students attending the region’s schools and to continue cultural education through the development of museum quality heritage kits. Sugt’stun instruction is to be provided by teachers who are working toward an Occupa-tional Endorsement Credential (OEC) in Sugt’stun. The credential is offered through Kodiak College eLearning / Dis-tance Education. This two year program will bring semi-fluent adults to the High Intermediate level of speaking and will give them an understanding of Sugt’stun teaching methods and materials. Five Sugt’stun Language Teachers are pursuing the OEC: Sugt’stun, and working toward an AA in education. We are also working toward developing addi-tional teaching materials for use in classrooms to provide cultural education. This goal is for the refinement of current heritage kits, the development of additional heritage kits, science night presentations with Elders and western scientists talking with students and community members, and summer science camps. A Heritage Preservation Department Plan has been approved by the Chugach Elders Council and will be presented to regional leadership for feedback. The purpose of the plan is to provide for sustainability in heritage programming. The plan has been under development for a year, with the Chugach Elders Council participating and with requests for re-vision to meet the goals set for future projects. The plan covers:

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Language Documentation, Eyak is considered to be a dead language with no fluent speakers living, and Sugt’stun is highly endangered language, based on the Stage of Language Stages Scale, (Fishman, 1991). The Prince William Sound dialect is considered a highly endangered language at Stage 9, stage 10 is a dead language. The Lower Ke-nai Peninsula dialect is endangered, at Stage 7 or 8. The stages are based on the age of fully fluent speakers, par-ticularly those of child bearing age. Revitalization of the language is a priority among tribal members and Chu-gachmiut beneficiaries.

Cultural Documentation, as with language documentation, cultural documentation is a priority among tribal members and Chugachmiut beneficiaries. Knowledge of cultural practices is an essential part of a person’s self-image and impacts wellbeing.

Heritage Education, to provide engaging programming for tribal members of all ages and in a variety of environ-ments.

Library Archive, available in digital and physical formats to provide resources for tribal members as they research for their own pleasure. This library can also be a foundation for local programs.

Tribal Support, to ensure that the department works toward the Chugachmiut mission to increase opportunities for self-determination.

Heritage, continued

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Tribal Services

Chugachmiut hosted a one day regional water operator meeting and invited staff from related state, federal and private fields, and the Alaska Native Tribal Health Consortium (ANTHC) staff to provide information about resources they of-fer. The group found that they have much in common and had several recommendations for each other to improve operations and/or staffing. By the end of the meeting, a regional working group was formed with plans to define the goals of the group. Chugachmiut supports the idea and has included a section addressing this in its strategic plan for BOD review and approval. The Regional Water Utility Working Group took opportunity of the BIA Providers Confer-ence to gather. During this meeting the group identified current needs to include increase in water supply for Tatitlek and possibly Nanwalek and Chenega Bay. ANTHC offered help obtaining the grants needed to conduct water supply studies, technical assistance and provide engineering designs for construction support and other help. The Chu-gachmiut Grants Department is currently looking for relevant grants to help with the study and development of need-ed water supply. In support of tribally owned clinics, Chugachmiut has been actively participating in a statewide “Village Built Clinic workgroup” that was established to come up with a distribution methodology for a long and hard fought increase to the program. Organizations are already positioning themselves but we are involved in the workgroup and will protect the interests of the region. Over the past 20 plus years that we’ve operated the Head Start program, we’ve had not had an increase to the budget but rather have had several cuts, struggled to keep up with inflation, and have had ‘waiting lists’ of children unable to enter the program due to lack of space and money. To address the lack of space in Nanwalek, Chugachmiut collaborat-ed with the Nanwalek IRA and the North Pacific Rim Housing Authority to apply for an Indian Community Develop-ment Block Grant to build a new facility. We are happy to report the application was successful. At the same time, Chugachmiut proposed to expand its Head Start program, increase its budget and requested matching cash for the new Nanwalek Head Start Building. We did not take no for an answer from the agency but repeatedly contacted them to share data about our lack of space, funding constraints, the disproportionate allocations made to programs throughout the state and shared stories about our children and their needs. After much advocacy and hard work by the Head Start team, we were awarded both requests and our ‘base’ budget has successfully been increased by over 88%!

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Trust & Forestry

Chugachmiut’s Yukon Fire Crew Project Crew began its first year in 2016 to conduct pre-fire suppression work by reducing fire hazardous fuel (HFR) loads along areas needing protection from wildland fire that is also known as fire fuel breaks and what the project crews call “HFR” work or “project work”. Other forestry work is also conducted de-pending on what contracts are being performed. The five-member crew was required to take wildland firefighter “Red-Card” training sponsored and/or delivered by Chugachmiut. The purpose was to meet insurance requirements and to qualify project crewmembers to be able to join Chugachmiut’s Yukon Fire Crew, a Type 2 initial attack standing wildland fire crew if and when necessary. Red-Card training qualifies crewmembers to be able to fight wildland fires. Last summer, four crewmembers came from Nanwalek including the Project’s crew boss. In 2017 the Project Crew will again be composed of five crewmembers. A new addition to Forestry contracting is the recently obtained contract with the U. S. Forest Service that will provide approximately eight weeks of funding for an eight person ‘youth worker’ crew. Work would begin summer of 2017 on the Chugach National Forest out of Moose Pass U. S. Forest Service Work Station. The federal government through Congress has reversed their long standing rule blocking Alaska Natives from re-questing the government take land into trust on their behalf. Chugachmiut is monitoring the situation and taking ad-vantage of U. S. Bureau of Indian Affairs (BIA) “Land into Trust” training the BIA is providing in anticipation that re-gional Tribes may need assistance in the application process.

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Financial Summary

Revenue

Expenses

Federal Compacts &

Grants

$11,912,084

State of Alaska

Grants

$674,359

Other Grants &

Contracts

1,366,263

Patient Service $525,657

Leases $175,842

Investment Income $296,694

Other Revenue $5,023,206

Contributed

Capital—Grants

$288,046

Health Restoration

Services

$7,291,208

Tribal

Development &

Operations

$3,656,720

Forestry & Fire

Management

$772, 750

General &

Administrative

Services

$4,149,901

For Fiscal Year ending September 30, 2016. Audit conducted by Porter & Allison, Inc., Certified Public Accountants

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Board of Directors

Francis Norman, Chair

Port Graham

Larry Evanoff, Vice Chair Chenega Bay

James Ujioka, Secretary Valdez

Robert Henrichs, Treasurer Eyak

John Kvasnikoff, Director Nanwalek

Arne Hatch, Director Qutekcak

David Totemoff Tatitlek

Chugachmiut, Anchorage (907) 562-4155 or 1-800-478-4155 Health Services Division, Seward (Northstar Health Clinic) (907) 224-3490 or 1-800-224-3076 Homer Field Office (907) 226-2006 Chugachmiut Crisis Line (907) 891-0444 or 1-844-0444 Arch Priest Nicholas Kompkoff Clinic, Chenega Bay (907) 573-5129 Ilanka Community Health Center, Cordova (907) 424-3622 Kachemak Bay Domestic Violence Tribal Advocate 1-877-907-8738 Nanwalek Clinic (907) 281-2250 or (907) 281-2251 Anesia Anahonak Moonin Clinic, Port Graham (907) 284-2241 or (907) 284-2295

Northstar Health Clinic, Seward (907) 224-3490 or 1-800-224-3076 Tatitlek Clinic (907) 325-2234 or (907) 325-2235 Alaska Native Health Consortium (907) 729-1900 Alaska Quitline 1-800-784-8669 Careline Crisis Intervention 1-877-266-4357 Chugach Alaska Corporation (907) 563-8866 or 1-800-858-2768 Chugach Regional Resources Commission (907) 224-5181 or (907) 562-4155 Domestic Violence & Sexual Assault Referral Hotline 1-877-907-8738 North Pacific Rim Housing Authority (907) 562-1444 or 1-800-274-1444

Contact Numbers

1840 Bragaw St., Ste. 110 Anchorage, AK 99508-3463

Phone: 907-562-4155 Toll Free: 800-478-4155 Fax: 907-563-2891

Website: Chugachmiut.org Follow us on Facebook:

Facebook.com/ChugachmiutALUTIIQ

Photo Credits

Cover: From DeLaguna Chugach History, p 103, Face Gylph from Hawkins Island; Page 2: submitted by Tosha Saincome; Page 3:

Submitted by Jen Kiokun; Page 4: submitted by Andy Mclaughlin; Page 5: submitted by Sue Steward; Page 6, Pictured: Samuel

Swenning; Page 7: submitted by Nathan Lojewski; Page 8, Pictured: Angela McKinney, submitted by self; Page 10, submitted by Cas-

sandra Stevenson; Page 11, Pictured: Shyla Krukoff, Cybill Berestoff, Rhoda Moonin, submitted by Cassandra Stevenson; Page 12,

Pictured: Liam Ukatish, submitted by Caroline Harvey; Page 13, Pictured: PJ Ukatish, John Petty, Public Service Staff Officer David

Isle, Sanky Ulak, Jeremy Cook, Jae Jay Greene submitted by Nathan Lojewski; Back Cover: submitted by Nikolai Ivanov